A Little History #11: Junod in China by Tom McDermott

In A Little History #8 I described the career of Dr. Marcel Junod before he joined UNICEF.  This article continues his story after arriving as UNICEF's first representative in China.

Junod: February 1948

In February 1948, UNICEF's first Representative in China, Dr. Marcel Junod, arrived in the Nationalist capital, Nanjing. His wife and young son followed, arriving a couple of months later by ship via Manila.

Junod with his young son, Benoit

Junod took over from Mary Pavlevsky, UNRRA's social welfare coordinator who had filled in as interim head of office. Not much is recorded about Pavlevsky except that she was recruited by UNRRA from the American Red Cross, where she served as a psychiatric social worker in North African military hospitals. She had traveled extensively in China and understood its social welfare landscape, though she likely carried over UNRRA’s focus on the bulk distribution of donated goods. To her credit, with no formal UNICEF background, Pavlevsky maintained the agency's presence through late 1947 and early 1948—a difficult transitional period when UNRRA was closing down and UNICEF had limited personnel of its own.

UNICEF wanted a fresh direction and counted on Junod to introduce a more dynamic approach centered on vaccination, public health, and balanced aid between Nationalist- and Communist-controlled territories. Junod brought extensive negotiation experience from years of crossing frontlines for the International Committee of the Red Cross (ICRC), managing relief operations across occupied Europe and Japan. He possessed the diplomatic skill required to navigate as China's civil conflict deepened.

Within four months, Junod and his small team established formal working relations with the Nationalist government, set up a central office in Nanjing, opened branch offices in major cities, recruited staff, and laid the groundwork for a full country program.

The Challenge

The challenge was staggering. UNRRA had expended an enormous budget of $500 million in two years, hampered by administrative confusion, disorganization, and corruption among both international staff and Nationalist officials.

UNICEF had a provisional budget of only $ 3.5 million (of a total $12 million allocated and held in reserve)  to serve a child population of 67 million, with most UNRRA promises of vehicles, supplies, and cash proving empty. What Junod’s team did inherit from UNRRA consisted mainly of US and Canadian milk powder and Australian raw cotton cloth for children's clothing.

The UNICEF team quickly established child feeding centers and clothing production units in a dozen major cities under Nationalist control. Yet it was clear that imported supplies would never meet the widespread needs across the country, particularly in the north.

A more fundamental issue faced both sides of the political divide: what little public health infrastructure existed before the Japanese occupation had largely collapsed by the end of World War II.

China's infant mortality rate stood at roughly 227 deaths per 1,000 live births. With approximately 20 million births each year, 4 to 5 million infants and young children died annually from preventable causes—many from neonatal tetanus due to unhygienic conditions and a lack of basic midwifery care.

Junod wanted UNICEF's first major step to be a vaccination campaign against tuberculosis, which was devastating Chinese children. He assembled five dedicated teams of doctors and nurses for the effort. While five urban vaccination teams were minuscule compared to the overwhelming need, it was a vital starting point.

In a letter to Maurice Pate in the summer of 1948, Junod wrote: "This is the most difficult mission I have ever had to face because its success does not depend on you or myself, or even the Government or the volunteer agencies, but the unlikely circumstances in which this country is today."

Newton Bowles, born and raised in China and then head of UNICEF's Asia Section at headquarters, visited in July 1948 and agreed with Junod's assessment. In his own report to Pate, Bowles wrote: "This is a most inopportune time to undertake Health and Welfare work in China. The Civil War dominates everything."

Civil War

Japanese Fort surrenders to Chinese Communists, late 1945

At the end of World War II, the cities and regions of eastern and northern China had been heavily occupied by Japanese forces, while the Nationalists controlled much of the south, west, and rural interior. Communist forces had waged a long guerrilla campaign and were positioned to secure areas vacated by the Japanese, gaining control of garrisons, weapons, and local forces. Farther north in Manchuria, Soviet forces facilitated the transfer of captured Japanese military infrastructure to Communist troops. This left the Nationalists and international aid operations, including UNRRA, largely confined to the south and west.

Divided China, 1948

Communist forces enter Beijing - January 31, 1949

Mao's drive to capture all of mainland China began in September 1948. In January 1949, Communist forces entered Beijing after a campaign of only 64 days, and by April 1949 they had crossed the Yangtze River. By May 1949 they had captured Shanghai, rapidly sweeping through remaining central and southern cities through the summer. Mao could then confidently declare the creation of the People's Republic of China (PRC) on October 1, 1949. On December 7, 1949, the Nationalist government ordered a final evacuation to Taiwan.

Two Aid Structures for Two Governments

Operationally, UNICEF dealt with the Nationalist relief structure, the Chinese National Relief and Rehabilitation Administration (CNRRA). Operating in parallel on the Communist side was the Communist Liberated Areas Relief Administration (CLARA). Limited cooperation between the two relief entities had broken down in 1946 as full-scale civil war resumed. Both UNRRA and subsequently UNICEF found themselves mostly restricted to Nationalist territory. UNRRA's official records indicate that only 2 to 3 percent (by weight) or 4 to 5 percent (by value) of its relief shipments reached Communist-controlled areas.

CNRRA and CLARA reflected the stark differences of their parent administrations. CNRRA was headed by Tsiang Tingfu, a US-educated historian and diplomat with a PhD from Columbia University who later served as the Republic of China’s permanent representative to the United Nations. 

Tsiang Tingfu, CNRRA (c. 1947)

Junod’s working relationship with Tsiang and CNRRA was affected by UNRRA's earlier compliance with Nationalist efforts to control aid distribution. Junod insisted on independent UNICEF field inspections, direct monitoring, and clear accountability before releasing food and medical stores, leading to firm exchanges between the two leaderships.

Dong Biwu, CLARA

CLARA was led by Dong Biwu, a veteran revolutionary leader and close associate of Mao Zedong who had traveled to the US as part of the Chinese delegation to the 1945 UN Conference. Dong later served as Acting Chairman of the People’s Republic of China.

Conversely, Junod’s interaction with Dong Biwu and CLARA proved professional and pragmatic. Junod respected CLARA's administrative discipline in the north. Dong, in turn, valued Junod's transparency and his insistence on personally inspecting field sites to verify aid delivery. This working relationship enabled UNICEF to establish initial programs in North China during a tumultuous geopolitical transition.

The Strategic Choice

UNICEF faced a pivotal policy decision in China in 1948. The organization had originally relied on the post-WWII European emergency relief model: importing milk powder, supplying basic medicines, and supporting existing public health services. By 1948, European programs were shifting toward long-term capacity building—such as developing local vaccine production, modernizing dairy processing, and establishing light manufacturing for footwear and clothing.

China presented a very different environment. The war with Japan had ended but a new war was just getting started. UNICEF found itself facing the same operational blockades, bureaucratic hurdles, and structural diversion of resources that had faced UNRRA. Most importantly, UNICEF was initially tied to a single side of a civil war, directly challenging its core principle that humanitarian assistance must reach children regardless of political boundaries.

The Nationalist blockade meant that the supplies rarely reached the communist north. In response, Pate and Junod agreed on a strategic shift toward local training and capacity building. They reallocated two-thirds of the China budget toward training village health workers and midwives.

To lead this initiative, Junod recruited Dr. Leo Eloesser, a surgeon already working in northern villages, along with Perry Hanson, a former UNRRA field officer who had grown up in China and spoke fluent Chinese. Junod also collaborated closely with Dr. Berislav Borcic, UNRRA's Chief of Health, who brought deep experience from China's rural health programs of the 1930s.

Following extensive diplomatic negotiations, Junod secured authorization from Nationalist authorities for a UNICEF team to travel north into Communist-controlled territory to launch rural health and midwifery training programs.

But Which Government Represented China?

There was a deeper structural dilemma beyond relief logistics. UNICEF's mandate to serve all children collided with international diplomatic recognition.

Chiang, Roosevelt, and Churchill - Cairo Conference, 1943

The United Nations and most Western governments recognized exclusively the Nationalist government under Chiang Kai-shek. As a key Allied power during World War II, Chiang had represented China alongside Roosevelt and Churchill at the 1943 Cairo Conference.

Chiang, First Head of State to Sign UN Charter - 1945

Following the war, China was designated one of five permanent members of the UN Security Council, with Chiang accorded the honor of being the first head of state to sign the UN Charter in 1945.

Maurice Pate held firm to the mandate that UNICEF must assist children on all sides of a conflict. Operating as a UN entity accredited to the recognized Nationalist government while providing aid within Communist-controlled zones required delicate diplomatic maneuvering—a precedent that would inform UNICEF's approach in subsequent conflict zones worldwide.

Setting a Strategy for Asia

In The Children and the Nations, Maggie Black notes that by April 1948, Maurice Pate and the Executive Board were planning to expand operations across Asia despite budget constraints.

To guide resource allocation across the region, UNICEF commissioned Dr. Thomas Parran, former US Surgeon General, and Dr. C. K. Lakshmanan, Director of the All-India Institute of Hygiene and Public Health, to conduct a comprehensive public health survey across 13 Asian nations.

In August 1948, the Board allocated an initial $300,000 for Indochina and partnered with the Rockefeller Foundation to include Dr. John Grant (father of future UNICEF Executive Director Jim Grant) on the survey team.

That same month, Pate requested Junod to undertake a field assessment in Korea. Junod's report provided the framework for UNICEF's eventual country program in Korea.

New York: January 1949

Pate recalled Junod to New York in January 1949 to brief senior leadership and the Executive Board on operations in China and plans for Korea. By then, the rapid advance of the civil war threatened the continuation of the main China office.

Junod presented a realistic evaluation to the Executive Board: ongoing military operations severely limited field implementation, leaving 80 percent of the China budget unspent. He noted that even full expenditure would represent a fraction of the total regional need. While the pivot toward rural training was effective, military developments were outpacing administrative setup. Although the small field team in the north had established operational ties with Communist health authorities, the bulk of UNICEF’s physical assets remained in Nationalist areas.

During his time in New York, Junod's health deteriorated. He had experienced severe pain and mobility issues while in Nanjing, and his condition now worsened significantly, leaving him unable to stand for extended periods.

Junod resigned from UNICEF in April 1949 to seek specialized medical care in Europe. Dr. Leo Eloesser was appointed to succeed him as UNICEF Representative in China.

Geneva and London: May 1949

In Geneva, radiologist Dr. Pierre Bardet diagnosed Junod with a large femoral cholesterol cyst accompanied by arterial calcification—a major vascular blockage requiring immediate surgical intervention.

Junod traveled to London for surgery in May 1949. The operation successfully removed the blockage and saved his life, but persistent circulatory limitations meant he could no longer stand long enough to perform surgery, ending his career as an active surgeon.

His Family Leaves Shanghai Under Fire: May 1949

While Junod was in London, his wife, Eugénie,  and three-year-old son, Benoit, prepared to leave Shanghai. Benoit was severely ill with amoebiasis and required specialized care at the Mayo Clinic. They secured passage on a ship bound for Manila.

Their departure coincided with the final push by the People's Liberation Army on Shanghai in mid-May 1949. Eugénie and Benoit managed to reach the harbor and board their vessel just as revolutionary troops entered the city.   Their ship pulled away under heavy artillery fire; the ship immediately following theirs was hit and sunk in the harbor.

Benoit, Junod, and Eugénie

Following Benoit's treatment in the US, the family reunited with Junod in London.

Retraining and Return to Geneva

Unable to practice surgery, Junod retrained in anesthesiology in Paris and London between 1949 and 1951, earning his diploma as a Fellow of the Faculty of Anaesthetists in November 1951.

Having previously declined the US Medal of Liberty in 1946 to maintain strict ICRC neutrality standards, Junod accepted the Grand Gold Medal for Peace in 1950, presented by Prince Carl of Sweden, in recognition of his humanitarian service in Ethiopia, Spain, and Japan.

Junod returned to Geneva in 1951 to establish the Department of Anesthesiology at the Cantonal Hospital of Geneva, heading the department throughout the decade. He rejoined active ICRC service in 1952, undertaking missions during the 1956 Hungarian crisis. In 1959, he was elected Vice-President of the ICRC and led a mission to Japan and Korea concerning the repatriation of Korean residents.

On April 3, 1952, Junod delivered a lecture to the Anglo-Swiss Society of London reflecting on his China assignment. Unfortunately, that text has never been added to online references. I hope one day that we can retrieve it, as it represents an important piece of UNICEF's history.

Death and Memorials

On June 16, 1961, Dr. Marcel Junod passed away after suffering a heart attack at the Cantonal Hospital in Geneva.

Monument to Junod in Geneva - an identical image to its twin in Hiroshima

Throughout his career, Junod exemplified the role he described in his memoir, Warrior Without Weapons (Le Troisième Combattant)—the neutral humanitarian worker providing assistance across conflict lines.

Although Junod’s UNICEF mission in China lasted only fourteen months, the strategic shift towards local capacity-building over distributing imported commodities was a key move in the right direction. Sadly, this shift in the right direction came too late and UNICEF, like most other foreign innovations, was soon overtaken by the communist revolution.

For UNICEF globally, however, the shift of strategy signaled a major turning point, away from distribution of relief supplies to capacity building with governments. It also signaled a change in global strategy, away from war relief in Europe and towards a determination to serve the needs of children wherever they might live.

UNICEF began its return to China in 1979, but that is another story.